• R J McCarthy, R Walker, P McAteer, J S Budd, and M Horrocks.
• The Royal United Hospital, Bath, UK.
• Eur J Vasc Endovasc Surg. 2001 Jul 1;22(1):13-8.

Objectivesthis study reviews and compares carotid endarterectomy (CEA) performed under local anaesthesia (LA) with CEA performed under general anaesthesia (GA) in a single institution.Methodsdata were collected prospectively from 240 CEA procedures. 140 GA CEA procedures are compared to 100 LA CEA procedures in terms of outcome, operative techniques, complications, and length of stay.Resultsthe groups were similar for age, gender distribution and preoperative risk factors. There were more asymptomatic patients in the LA group. There were no significant differences in death, stroke or death/stroke rate between the two techniques. LA CEA was associated with lower shunt rate (LA 13%, GA 50%, p < 0.001), lower incidence of intraoperative hypotension (LA 8%, GA 40%, p < 0.001), decreased hospital stay (median (IQ); LA 2 (1-2), GA 3 (1-4), and a cost saving of pound235 per CEA procedure.Conclusionscarotid endarterectomy can be performed safely under local anaesthesia with the advantage that LA CEA enables the surgeon to monitor and selectively shunt patients more accurately. In addition LA CEA is associated with a shorter hospital stay and important cost savings.Copyright 2001 Harcourt Publishers Limited.

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